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Hospital at Home, An Innovative Approach for Elderly Care During the COVID-19 Pandemic

Editorial Letter | DOI: https://doi.org/10.31579/2693-4779/020

Hospital at Home, An Innovative Approach for Elderly Care During the COVID-19 Pandemic

  • MD Abu Bashar 1

1 Assistant Professor, MMIMSR, MM Deemed University, Mullana, Ambala, Haryana, India

*Corresponding Author: Abu Bashar, Assistant Professor, MMIMSR, MM Deemed University, Mullana, Ambala, Haryana, India.

Citation: A Bashar. (2021) Hospital at Home, an innovative approach for Elderly care during the COVID-19 Pandemic. Clinical Research and Clinical Trials. 3(1); DOI:10.31579/2693-4779/020

Copyright: © 2021, Abu Bashar. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Received: 17 January 2021 | Accepted: 05 February 2021 | Published: 08 February 2021

Keywords: COVID-19 pandemic; world health organization; public health emergencies

Abstract

The COVID-19 pandemic has profoundly affected the elderly people (those aged 60 years or above as per the definition by the World Health Organization) who are found to have higher rates of infection and poorer health outcomes in this pandemic compared to other age groups. Nevertheless, elderly adults, despite having a wide range of chronic illnesses, are experiencing critically inadequate access to care as healthcare organizations are emphasizing more on patients primarily affected by COVID-19. Furthermore, Elderly people remain most vulnerable in this pandemic as most of the nations do not have adequate preparedness to ensure acute and chronic geriatric care in public health emergencies.

Introduction

The COVID-19 pandemic has profoundly affected the elderly people (those aged 60 years or above as per the definition by the World Health Organization) who are found to have higher rates of infection and poorer health outcomes in this pandemic compared to other age groups [1,2]. Nevertheless, elderly adults, despite having a wide range of chronic illnesses, are experiencing critically inadequate access to care as healthcare organizations are emphasizing more on patients primarily affected by COVID-19 [3,4]. Furthermore, Elderly people remain most vulnerable in this pandemic as most of the nations do not have adequate preparedness to ensure acute and chronic geriatric care in public health emergencies [4,5].

Although community-based gerontological care may alleviate health-related problems of elderly people, such efforts may appear to be inadequate for acute exacerbation of chronic diseases or other clinical scenarios that cannot be avoided [6,7].  In these circumstances, visiting health centers may expose the older adults to corona virus, or other hospital acquired infections, which could be a perfect disaster leading to adverse health outcomes.  

Hospital at Home (HAH) is a concept that emphasizes on providing active treatment in the home environment of a patient who would otherwise requires in-patient hospital care [8]. Such services, originating in the mid-twentieth century, has been increasingly adopted by many healthcare organizations in the US, Canada, Netherlands, Australia, and the UK [8,9].  Under  the  HAH  program,  an  emergency  or community-level healthcare provider identifies  a  patient with a health problem and conducts an initial assessment using predetermined criteria to check if the patient needs hospitalization or if the HAH  care  can  effectively  fulfill the  requirements  of  clinical  care [9].  For understanding the concept of HAH, suppose a patient requiring surgical intervention may need acute care through hospitalization, but the post-operative and follow-up care can be delivered through HAH. Clinical conditions prevalent in  elderly  adults,  including congestive  heart  failure,  chronic  obstructive  pulmonary  disease, cellulitis , or community-acquired pneumonia can be effectively treated through HAH. Once HAH is established, a healthcare team is assigned to ensure that the patient’s home is transformed for providing  hospital-grade  care  through  scheduled  visits  by  healthcare  providers  and  coordinated care facilities on an emergency basis. As required, clinical and laboratory services can be delivered through  HAH  care  and the  patient can  be discharged  once  a  clinically stable  health status  is achieved [10] . The  increasing  adoption  of  HAH  in recent  years is  informed  by  a  wide  range  of  advantages  that includes lowering the demand for hospital beds,  reducing operational costs of clinical care,  and decreasing the risks of hospital-acquired infections [9].  However, there are several additional or collateral benefits for the elderly population who receive HAH.  First,  HAH  offers hospital-level  care  at  home  environment,  which  can  be  desirable  for  older  adults  who  prefer to receive  clinical  services  in their  regular  environment  and  close  contacts  with  their  informal caregiver rather than institutionalized care [8,9]. Secondly, elderly people usually require long-term care for chronic conditions that usually does not require acute in-patient care. Such services can be organized within the scope of HAH. Thirdly, the autonomy and control over own health and associated decisions can be ensured within the home environment, which may contribute to better mental health and overall psycho social wellbeing in elderly peoples [11].  Last but not the least, in-patient care may provide acute medical or surgical care,   but   it   clearly   lacks   a   comprehensive   approach, including   psychological   support, gerontological  social  care,  and  a  wide  range  of  community  resources  that  can  be  delivered  at doorstep rather than at the in-patient setting [9,11].

References

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